Medication Administration

  1. Pharmacokinetics
    The study of drug concentration
  2. What are the pre-requisites for safe and effective drug administration?
    • Pharmacokinetics
    • Growth and development
    • Nutrition
    • Mathematics
  3. Pure Food and Drug act of 1906
    • Designated official standards for medications;
    • specified standards for medication labeling especially those that were habit forming;
    • also established the Food and Drug Administration (FDA)
  4. Med Watch Program
    This voluntary program encourages nurses and other health care professionals to report when a medication, product, or medical event causes serious harm to a client by completing the MedWatch form
  5. Chemical Name for medication....
    • provides an exact description of the medication's composition and molecular structure.
    • Nurses rarely use chemical names in clinical practice.
    • An example of a chemical name is N-acetyl-para-aminophenol. =Tylenol
  6. Generic name of a medication is
    • a non-proprietary name
    • The generic name becomes the official name listed in official publications such as the USP
    • example is acetominaphen = tylenol
  7. Trade name
    • The trade name, brand name, or proprietary name is the name under which a manufacturer markets a medication.
    • The trade name has the symbol™ at the upper right of the name, indicating that the manufacturer has trademarked the medication's name
  8. What are some guidelines for safe narcotic administration and control?
    • Store all narcotics in a locked, secure cabinet or container
    • •Narcotics are frequently counted. Usually counts are made on a continuous basis with the opening of narcotic drawers and/or at shift change.
    • •Report discrepancies in narcotic counts immediately.
    • •Use a special inventory record each time a narcotic is dispensed. Records are often kept electronically and provide an accurate ongoing count of narcotics used and remaining as well as information about narcotics that are wasted
    • .•Use the record to document the client's name, date, time of medication administration, name of medication, dose, and signature of nurse dispensing the medication.
    • •If a nurse gives only part of a premeasured dose of a controlled substance, a second nurse witnesses disposal of the unused portion. This must be recorded
  9. Medication is classified by
    • the effect of the medication on a body system
    • the symptoms the medication relieves
    • or the medication's desired effect
  10. What are some factors that influence absorption?
    • the route of administration,
    • ability of the medication to dissolve,
    • blood flow to the site of administration,
    • body surface area,
    • and lipid solubility of medication.
  11. Elixers are
  12. troche s are
  13. Medications are quickly absorbed if placed....
    on mucous membranes and respiratory airways because these tissues contain so many blood vessels
  14. Orally administered medications are typically slow because
    they must pass through the GI tract
  15. IV medications produce the most rapid absorption because
    they enter systemic circulation
  16. Medication is absorbed at a faster rate when there is a ____ surface area
    • large.
    • This is why the majority of medications are absorbed in the small intestine rather than the stomach.
  17. Because the cell membrane has a lipid layer, highly lipid-soluble medications easily cross the cell membrane and are absorbed....
  18. What is a therapeutic effect?
    the expected or predictable physiological response a medication causes
  19. What is a side effect?
    predictable and often unaviodable secondary effects produced at a usual therapeutic dose.
  20. What is an adverse effect?
    • unintended, undesirable, and often unpredictable severe responses to medications
    • may often take weeks or months to develop
    • early recognition is key
  21. what is a toxic effect?
    develop after prolonged intake of a medication or when a medication accumulates in the blood because of impaired metabolism or excretion
  22. What is an idiosyncratic reaction?
    • overreaction or underreaction of a medication or a reaction that is different from normal.
    • ie children that takes benedryl becomes agitated and excited instead of drowsy
    • not always predictable
  23. What is an allergic reaction?
    • unpredictable responses to a medication.
    • Some clients become immunologically sensitized to the initial dose of a medication.
    • With repeated administration, the client develops an allergic response to the medication, its chemical preservatives, or a metabolite.
    • The medication or chemical acts as an antigen, triggering the release of the body's antibodies.
  24. What is an anaphylactic reaction?
    • life threatening or severe allergic reactions
    • characterized by sudden constriction of bronchiolar muscles, edema of the pharynx and larynx, and severe wheezing and shortness of breath.
  25. Sublingual administration is
    under the tongue
  26. Buccal administration is
    when a medication is pushed against the cheek and absorbed through cappilaries
  27. What is a synergistic effect?
    the combined effect of the two medications is greater than the effect of the medications when given separately
  28. serum half-life
    the time it takes for excretion processes to lower the serum medication concentration by half
  29. onset
    the time it takes for the medication to produce a response
  30. Through
    Minimum blood serum concentration of medication reached just before the next scheduled dose
  31. Plateau
    Blood serum concentration of a medication reached and maintained after repeated fixed doses
  32. List 2 oral routes
    • Sublingual
    • Buccal
  33. What are 4 major parenteral routes of administration?
    • 1.Intradermal (ID): Injection into the dermis just under the epidermis
    • 2.Subcutaneous (Sub-Q): Injection into tissues just below the dermis of the skin
    • 3.Intramuscular (IM): Injection into a muscle
    • 4.Intravenous (IV): Injection into a vein
  34. Topical administration consists of
    • skin
    • mucous membranes (includes vaginal and rectal)
    • inhalation
    • intraocular
    • otic (ear)
    • nasal
  35. Distribution depends on
    • Circulation: Heart rate, blood volume (if u are anemic or low blood volume=slow down)
    • Permeability: does it pass placental barrier? Does pass the blood brain barrier?
    • Protien binding: the degree by which the med binds to proteins, such as albumin. (albumin decreases in geriatric population which increases the risk of toxic effects
  36. Where does biotransformation occur?
    usually in the liver
  37. How is alcohol excreted?
    the lungs
  38. What is a potentiating effect?
    • a form of synergistic effect
    • 2 meds given together that gives an increased effect of one of the medications
  39. What is an inhibiting effect
    2 meds given together that decreases or slows down the effect of one of the medications
  40. A prescriber can be...
    • a nurse practioner
    • physician
    • physicians assistnat
  41. What is a standing order?
    is carried out until the prescriber cancels it by another order or until a prescribed number of days elapse
  42. What is a NOW order
    A now order is more specific than a one-time order and is used when a client needs a medication quickly but not right away, as in a STAT order
  43. A unit dose is considered
    a 24 hour dose of meds the pt takes
  44. What are some examples of distribution systems
    Special medication rooms, portable locked carts, computerized medication cabinets, and individual storage units next to clients' rooms are examples of storage areas used
  45. The 6 rights are
    • Right:
    • medicaton
    • dose
    • patient
    • route
    • time
    • documentation
  46. MAR
    Medication administration record
  47. What kind of technique is administration by injection?
  48. Which syringe is described as having a long thin barrel and a pre attached needle on it?
    tuberculin syringe
  49. What are the best sub cutaneous injection sites?
    • outer posterior aspects of the arm
    • abdomen above ileac crest
    • anterior aspects of the thighs
    • 45-90 degrees
  50. Intra muscular injection sites
    • 90 degrees
    • Ventrogluteal: find ball of femur and hip bone
    • Vastus Lateralus: one hand above the knee and other below groin. frequently used in infants
    • deltoid: where scapula meets clavicle. not used in pts with underdeveloped muscles ( infants). used in toddlers older children and adults
    • ...faster absorption than SubQ
    • Use Z track method
  51. Intradermal injections
    • are used for skin testing (tb)
    • 5- 15 degrees
  52. Intravenous bolus' are usually
    • pain meds
    • they are concentrated and then introduced into systemic circulation
    • rapid onset
Card Set
Medication Administration
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